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Predicting Stroke Outcomes Using Ankle-Brachial Index and Inter-Ankle Blood Pressure Difference

 Minho Han  ;  Young Dae Kim  ;  Jin Kyo Choi  ;  Junghye Choi  ;  Jimin Ha  ;  Eunjeong Park  ;  Jinkwon Kim  ;  Tae-Jin Song  ;  Ji Hoe Heo  ;  Hyo Suk Nam 
 JOURNAL OF CLINICAL MEDICINE, Vol.9(4) : 1125, 2020-04 
Journal Title
Issue Date
ankle-brachial index difference ; inter-ankle blood pressure difference ; outcome ; peripheral artery disease ; stroke
Background: This study investigated the association of high ankle-brachial index difference (ABID) and systolic inter-ankle blood pressure difference (IAND) with short- and long-term outcomes in acute ischemic stroke patients without peripheral artery disease (PAD). Methods: Consecutive patients with acute ischemic stroke who underwent ankle-brachial index (ABI) measurement were enrolled. ABID was calculated as
right ABI-left ABI
. IAND and systolic inter-arm blood pressure difference (IAD) were calculated as
right systolic blood pressure - left systolic blood pressure
. Poor functional outcome was defined as modified Rankin Scale score ≥3 at 3 months. Major adverse cardiovascular events (MACEs) were defined as stroke recurrence, myocardial infarction, or death. Results: A total of 2901 patients were enrolled and followed up for a median of 3.1 (interquartile range, 1.6-4.7) years. Among them, 2643 (84.9%) patients did not have PAD. In the logistic regression analysis, ABID ≥ 0.15 and IAND ≥ 15 mmHg were independently associated with poor functional outcome (odds ratio (OR), 1.970, 95% confidence interval (CI), 1.175‒3.302; OR, 1.665, 95% CI, 1.188‒2.334, respectively). In Cox regression analysis, ABID ≥0.15 and IAND ≥ 15 mmHg were independently associated with MACEs (hazard ratio (HR), 1.514, 95% CI, 1.058‒2.166; HR, 1.343, 95% CI, 1.051‒1.716, respectively) and all-cause mortality (HR, 1.524, 95% CI, 1.039‒2.235; HR, 1.516, 95% CI, 1.164‒1.973, respectively) in patients without PAD. Conclusion: High ABID and IAND are associated with poor short-term outcomes, long-term MACE occurrence, and all-cause mortality in acute ischemic stroke without PAD.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Jinkwon(김진권) ORCID logo https://orcid.org/0000-0003-0156-9736
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
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